Active NPI
Megan Lynn Dickman
- Physical Therapist
- Roseville, MN
National Provider Identifier
1578045571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10894
- Practice address
- 1835 County Road C W Ste 41
Roseville, MN 55113-1343 - Phone
- (651) 638-0080
- NPI assigned
- Sep 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10894 | MN | Primary |
Addresses
Primary practice location
1835 County Road C W Ste 41
Roseville, MN 55113-1343
Mailing address
3118 W Lake St Unit 221
Minneapolis, MN 55416-6806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10894 | MN | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novacare Outpatient Rehabilitation East Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Vadnais Heights, MN
- NPI 1518963909
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1578045571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3118 W LAKE ST UNIT 221",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554166806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 COUNTY ROAD C W STE 41",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551131343",
"telephone_number": "651-638-0080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKMAN",
"first_name": "MEGAN",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-05",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "10894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.